Individual provider Active NPI

Ruth C Flynn, MD

  • Psychiatry Physician
  • Greenville, NC
National Provider Identifier
1609877133
Registry record updated Jan 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
200300975 Issued in NC
Practice address
502 Red Banks Rd Ste a
Greenville, NC 27858-5751
Phone
(252) 758-4810
Fax
(252) 758-3790
NPI assigned
Aug 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 200300975 NC Primary

Addresses

Primary practice location

502 Red Banks Rd Ste a
Greenville, NC 27858-5751

Mailing address

PO Box 20128
Greenville, NC 27858-0128
Phone (252) 758-4810

Other identifiers 2

IdentifierTypeStateIssuer
8902487MedicaidNC
135CNOtherNCBCBS NC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031223000819 NC Practitioner - Psychiatry 3375441611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200300975NCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Sep 1, 2011 Accepting new patients
Mindpath Care Centers, North Carolina, PLLC Psychiatry PastSince Oct 7, 2020 Accepting new patients

Locations

600 Moye Blvd
Greenville, NC 27834
Phone (252) 744-1111

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

628 E 12th St
Washington, NC 27889
Phone (252) 975-4100

1308 Highland Dr
Washington, NC 27889
Phone (252) 946-3666

1379 Cowell Farm Rd
Washington, NC 27889
Phone (252) 975-8852

1211 Highland Dr
Washington, NC 27889
Phone (252) 975-8330

210 W Liberty St
Williamston, NC 27892
Phone (252) 792-5151

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294185600000",
    "number": "1609877133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20128",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278580128",
            "telephone_number": "252-758-4810",
            "fax_number": "252-758-3790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 RED BANKS RD STE A",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585751",
            "telephone_number": "252-758-4810",
            "fax_number": "252-758-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "RUTH",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2011-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "200300975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8902487",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "135CN",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.